Patient-Doctor Global Communication Assessment - ICM Research

Patient-Doctor
Global Assessment – UK Report
Insights from the Worldwide Independent Network (WIN) of Market Research
January 2011

Key UK insights
Summary of insights from a UK perspective
The UK relies heavily
on HCPs for advice –
89% do - but are also
web-savvy with 37%
looking for information
on online product /
disease sites
A third of UK patients
go to a doctor they
haven’t seen before
Multi-source
information
UK patients tend not
to be aware of
alternatives to what
they’re prescribed –
34% compared to 41%
globally
Self-reliance
Want choice
usually happy with
prescription
Around a half of UK
patients would
recommend their
doctor and rate them
relatively highly for
communication
UK patients are less
likely to rely on a
doctor to keep them
healthy and are more
likely to visit the doctor
for acute conditions

Source of Information
Q. In the past year, which of the following have you used to gain information about your health?
• Globally, patients gain most of the information about their health
from health professionals (71%).
• Furthermore, although friends and family (47%) are the next
preferred source to gain health information they are far behind
health professionals.
UK patients rely heavily on
healthcare professionals (HCPs)
for information – but they are
also web-savvy

Patient Trust
Q. I rely on a doctor to keep me healthy.
Spain
88%
• The majority (67%) of individuals
throughout the world rely on a
doctor to keep them healthy.
• Scores were lowest in Austria,
China, Switzerland, the UK, and
Iceland.
India
France
Japan
Netherlands
Italy
Turkey
Russia
78%
78%
77%
77%
83%
82%
81%
Lebanon
77%
Korea
73%
UAE
73%
Bulgaria
71%
Brazil
70%
USA
69%
UK respondents may rely on HCPs for
information, but the majority don’t
think their doctor is responsible for
keeping them healthy.
Only Iceland believes responsibility lies
less with a doctor.
Saudi Arabia
Canada
Australia
Pakistan
Austria
China
Switzerland
UK
49%
49%
48%
46%
57%
56%
63%
68%
Strongly/Slighty
Agree
Iceland
41%
TOTAL
67%

Purpose of Visit
Q. What was the main purpose to your most recent visit with the doctor?
Patients in the UK are less likely to
visit the doctor with no specific
condition (11%) e.g. for health
check ups
Patients in the UK and Japan are
those who most frequently visit the
doctor to follow up on a previously
diagnosed condition (48%).
• Most patients see physicians for a specific
problem - either for a follow-up on a previously
diagnosed condition (37%) or make a first
appointment for a new problem (33%).
• Chinese are the least likely to follow-up with a
doctor on a previously diagnosed condition
(14%).
Regular
appointment for
no specific
condition
Follow-up for
previously
diagnosed
condition
First
appointment for
a new problem
Other/
DNK/DNA
China 39% 14% 42% 4%
Italy 38% 35% 17% 10%
USA 36% 41% 16% 7%
Switzerland 35% 22% 33% 9%
Brazil 32% 39% 25% 3%
Russia 31% 28% 29% 12%
Spain 29% 45% 21% 6%
Canada 27% 41% 20% 12%
Austria 26% 31% 29% 14%
Pakistan 26% 45% 17% 13%
Saudi Arabia 20% 34% 45% 1%
France 20% 34% 28% 18%
Bulgaria 19% 44% 28% 9%
Lebanon 18% 43% 37% 1%
Korea 17% 25% 44% 14%
UAE 16% 27% 49% 8%
Iceland 15% 31% 33% 20%
Australia 14% 43% 32% 11%
Japan 14% 48% 27% 11%
Turkey 11% 34% 55% 1%
UK 11% 48% 31% 10%
Netherlands 7% 40% 41% 12%
India 3% 35% 62% 0%
TOTAL 21% 37% 33% 9%

Main Conditions
Q. Please specify your main problem or condition
Globally, the main problem or
condition an individual will go
to see the doctor for is the
flu/feeling ill/fever (12%).
In the UK patients tend to
visit the doctor for more
complicated conditions such
as Joint and muscle pain or
depression and anxiety and
less for flu and fevers when
compared to the global
average
Condition Global UK
Flu / feeling ill / fever 12% 3%
Hypertension / high blood pressure / heart disease 10% 9%
Joint or muscle pain / arthritis 9% 11%
Stomach pain / digestive problem 5% 3%
Rash / skin problem 4% 6%
Diabetes 4% 5%
Physical injury (scrape, cut, bruise, broken bone, etc.) 4% 2%
Allergies 3% 2%
Depression / anxiety 3% 6%
Headache 2% 1%
High cholesterol 2% 3%
Pregnancy 2% 1%
Breathing difficulty / asthma 3% 2%
Genital infection / problem 1% 1%
Fatigue / feeling tired 1% 1%
Cancer 1% 2%
Frequent or burning urination 1% 1%
Inability to sleep well 1% 1%
Constipation 0% 0%
Other 21% 23%
I don't know / I prefer do not to answer / No response 12% 6%

Patient Visit
Q. Have you seen this doctor before?
A third of UK patients saw a doctor
they hadn’t seen before.
Spain
France
Bulgaria
Canada
80%
79%
78%
76%
Austria
76%
Italy
75%
Switzerland
75%
Australia
72%
USA
72%
• On average, 58% of respondents return
to see a doctor they have seen more
than once.
Lebanon
Netherlands
UK
Japan
71%
70%
66%
64%
• Citizens of Spain, France and Bulgaria
are most likely to have seen their
doctor before.
Iceland
Russia
UAE
India
58%
54%
51%
51%
• On the other hand, Chinese least
frequently see a doctor they have seen
before with only 16% who responded
that their last visit was with a doctor
they had previously seen.
Korea
Pakistan
Brazil
Saudi Arabia
Turkey
China
TOTAL
16%
34%
39%
38%
46%
46%
Yes, more than
once
58%

Patient Choice
Q. I prefer that my doctor just tell me what to do rather than give me choices.
UK patients don’t like to be told what to do
and they want choices of information.
• Globally, 60% of respondents prefer that a doctor
just tell them what to do rather than give them
choices.
• Most citizens preferred being told what to do in
Italy (87%), Turkey (84%) and Spain (83%).
• Austria, Canada, the USA, Australia and the UK are
the countries where most respondents would not
prefer being told what to do by their doctor with
72%, 64%, 62%, 58%, and 56% of them respectively
who would disagree with this statement.
Wants
Choices
Told what to
do DNK/DNA
Austria 72% 28% 1%
Canada 64% 34% 2%
USA 62% 37% 1%
Australia 58% 41% 1%
UK 56% 39% 5%
Iceland 47% 45% 8%
China 46% 55% 0%
Japan 40% 54% 6%
Russia 40% 59% 1%
Pakistan 36% 61% 3%
Netherlands 36% 62% 3%
Switzerland 34% 62% 4%
Brazil 31% 67% 2%
France 30% 68% 2%
India 28% 67% 5%
Korea 24% 76% 1%
Saudi Arabia 21% 78% 1%
UAE 20% 79% 1%
Lebanon 18% 82% 0%
Bulgaria 18% 75% 7%
Turkey 14% 84% 2%
Spain 14% 83% 4%
Italy 13% 87% 0%
TOTAL 38% 60% 3%

Prescription Medication and Alternatives
Q. Are you aware of any alternative to your prescription medication that was available or are you only
aware of the medication you were prescribed?
Q. Did you and your doctor discuss any alternative medications to the one you were prescribed?
Q. Why do you think you were not prescribed the alternative?
When it comes to prescriptions though,
only a third of UK patients are aware of
any alternatives.
• Overall, 41% of respondents throughout the
world were aware of an alternative to their
prescribed medication. Of those, an average
of 64% discussed these alternatives with their
doctor.
• Furthermore, a high of 70% who were aware of
an alternative believe they were prescribed
the best medication for their condition by
their doctor.
• Icelanders (61%), Russians (60%), Austrians
(58%) and Americans (57%) are the most aware
of alternatives while Koreans (20%) and
Spaniards (18%) are the least aware.
Yes -
discussed any
alternative
Prescribed
the best
medication
Aware of
alternative
Iceland 61% 59% 32%
Russia 60% 78% 69%
Austria 58% 75% 75%
USA 57% 72% 68%
Australia 54% 72% 81%
Canada 51% 69% 75%
China 48% 87% 86%
Japan 48% 61% 70%
India 46% 35% 57%
France 44% 66% 73%
Netherlands 40% 60% 77%
Of those
UK 34% 66% 79%
aware of an
Pakistan 31% 43% 81%
alternative
Turkey 29% 6% 32%
Switzerland 28% 65% 66%
Brazil 27% 51% 67%
Lebanon 27% 45% 78%
Italy 25% 44% 36%
UAE 25% 60% 68%
Saudi Arabia 24% 50% 68%
Bulgaria 23% 86% 76%
Korea 20% 61% 65%
Spain 18% 45% 44%
TOTAL 41% 64% 70%

Recommending your doctor
Q. Please rate the doctor you most recently met with on a scale of 0-10, where 0 means you would
never recommend and 10 means you would definitely recommend this doctor
• Respondents who give a 9 or higher out of 10
to this question are referred to as promoters
and are considered as individuals who would
recommend their doctor.
Australia
Austria
Switzerland
Canada
USA
66%
62%
62%
61%
60%
18%
20%
31%
26%
26%
8%
17%
8%
12%
13%
• Overall, less than half (44%) of respondents
are likely to recommend their doctor.
Turkey
Lebanon
Iceland
59%
56%
55%
23%
35%
27%
19%
9%
16%
• Overall, Australians are the most likely to
recommend their doctors with 66% of
promoters. Meanwhile, Chinese are the least
likely to recommend their doctors with a low
promoter score of 6%.
Brazil
UK
Saudi Arabia
France
UAE
Spain
Bulgaria
53%
49%
49%
49%
48%
47%
42%
31%
30%
28%
34%
33%
38%
32%
16%
19%
21%
17%
18%
12%
25%
India
36%
48%
14%
Italy
35%
44%
21%
About half of all UK respondents would
recommend their doctor – above the
global average
Russia
Pakistan
Netherlands
Japan
Korea
33%
30%
29%
18%
16%
35%
42%
31%
39%
57%
50%
36%
35%
29%
11%
China
6%
17%
77%
Total
44%
32%
22%
Promoters: rating 9-10
Fence Sitters: Rating 7-8
Detractors: Rating of 6-0

Global Net Promoter (NPS) Score Summary Summer 2010
NPS (Net Promoter Score) around the world
High NPS scores
More citizens in Australia, Austria, Brazil, Canada,
Lebanon, Spain, Switzerland, Turkey and the USA are
likely to recommend their doctor with NPS scores
above average.
Average NPS scores
Bulgaria, France, India, Italy, the
Netherlands, Saudi Arabia, the UAE
and the UK have average NPS
Scores.
*The data for this graph is based on questions presented on slide 10.
Low NPS scores
Respondents in China, Japan, Korea,
Pakistan and Russia have very low NPS
Scores.
The Net Promoter Score is obtained by asking customers a single question on a 0 to 10 rating scale: "How likely is it that you would recommend our company
to a friend or colleague?" Based on their responses, customers are categorized into one of three groups: Promoters (9-10 rating), Passives (7-8 rating), and
Detractors (0-6 rating). The percentage of Detractors is then subtracted from the percentage of Promoters to obtain a Net Promoter score.*

CAT (Communication Assessment Tool)
Q. Thinking of your most recent visit, please rate the doctor’s communication with you.
• The Communication Assessment Tool (CAT) measures the
interpersonal and communication skills. This score is obtained by
asking 15 questions and employs a five-point response scale, with
5=excellent. Fourteen items focus on the physician and one targets
the staff.*
• The CAT score is the average of the excellent ratings for the 15
physician communication skill attributes (see previous slide).
• Globally, the average CAT score of the 23 surveyed countries is at
29%.
• Countries with the highest CAT scores include the USA, Saudi Arabia,
Australia and Canada with scores of 52%, 51%, 49%, and 47%
respectively.
• India (17%), Korea (15%), Turkey (12%), Japan (11%), Italy (11%),
Pakistan (7%), and China (4%) have the lowest scores.
UK respondents score their doctors
relatively highly on communication
CAT
Country (Communication
Assessment Tool)
USA 52%
Saudi Arabia 51%
Australia 49%
Canada 47%
UK 42%
Austria 40%
Lebanon 40%
France 39%
UAE 37%
Switzerland 35%
Brazil 30%
Iceland 30%
Bulgaria 25%
Netherlands 23%
Russia 22%
Spain 21%
India 17%
Korea 15%
Turkey 12%
Japan 11%
Italy 11%
Pakistan 7%
China 4%
Total 29%
12
*Source: http://www.pec-journal.com/article/S0738-3991(07)00178-4/abstract

Global Communication Assessment Tool (CAT) Summary
Summer 2010
Patient-Doctor Relationship around the world
High CAT scores
Citizens in Australia, Austria, Canada, Lebanon, Saudi
Arabia, the UK and the USA are very satisfied with
their communication with their doctors with CAT
scores above average
Average CAT scores
Respondents in Brazil, Bulgaria,
France, Iceland, the Netherlands,
Russia, Spain, Switzerland and the
UAE have average CAT scores
Low CAT scores
Citizens in China, Japan, Korea, India, Italy,
Pakistan and Turkey are the least satisfies
with their doctor with below average CAT
scores
*The data for this graph is based on questions presented on slide 12.

14
Appendix

Background & Research
Background
WIN, the Worldwide Independent Network of Market Research,
the largest independent organization of Market Research firms
with members in 51 countries, prepared this landmark review of
patient-physician communication.
Research
Patient-doctor communication critically influences the effectiveness of
medical education initiatives, treatment decisions and patient
compliance to recommended treatments.
WIN conducted this ground-breaking study on patient-doctor
communication throughout the world to provide the healthcare
stakeholders with a better understanding on how patients perceive
communication skills of their doctor, how patients engage their
physician, how treatment choices are influenced, the frequency and
preferred modes of interaction and sources of influential information.

Context and Methodology
• This global study includes 22,581
respondents over the age of 18 years old
who visited a doctor within the last 12
months.
• The survey was conducted from the end of
May to the beginning of August 2010 in 23
countries throughout the world.
• The table to the right presents a summary of
the methodology used in each country to
conduct this survey.
• Each sample is representative of its
country’s population in terms of sociodemographic
variables. Sample sizes ensure
accurate generalizations to the total
population and allow a very precise
interpretation of the results.
• The margin of error per country is between
+/- 2.42% and 4.98%.
Country Firm Method Sample
Margin of
Error
Australia Colmar Brunton Online 1028 3.06%
Austria Gallup Austria CATI 959 3.16%
Brazil Ibope Inteligencia Face to Face 1373 2.64%
Bulgaria BBSS Face to Face 1000 3,10%
Canada Leger Marketing Online 1036 3.04%
China CRC Research Online 1000 3.10%
France BVA CAWI 1000 3.10%
Iceland Capacent Online 717 3.66%
India MaRS Face to Face 1001 3.10%
Italy Doxa Face to Face 762 3.55%
Japan NRC Research Online 1000 3,10%
Korea Gallup Korea Online 1000 3.10%
Lebanon PARC CATI 400 4.90%
Netherlands Marketresponse Online 947 3.18%
Pakistan Gallup Pakistan Face to Face 1514 2,52%
Russia Romir Online 910 3.25%
Saudi Arabia PARC CATI 1047 3.03%
Spain Instituto DYM Face to Face 496 4.40%
Switzerland Isopublic Face to Face 388 4.98%
Turkey Barem Research CATI 1017 3.07%
UAE PARC CATI 1097 2.96%
UK ICM Research Online 1640 2.42%
USA TRiG Online 1249 2.77%